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Some chelators, such as D-penicillamine, also cause direct neurotoxicity, likely by crossing the blood-brain barrier and disrupting copper-dependent central nervous system enzymes, impairing energy metabolism, and increasing oxidative stress [245, 246]

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Most patients taking this medication had long-lasting improvement with their heavy periods

For example, DSIP may regulate the activity of intracellular calmodulin or affect the interaction between calcium ions and other signaling molecules in cells, thereby affecting cell metabolism and growth adaptability

Additionally, referring patients visual impairments or thickened toenails to a podiatrist for nail trimming